Challenge to Psychiatry
Perhaps the most obvious set of theories to be scrutinized in Laing’s work are those which guide the psychiatric establishment and, in particular, psychopathology. Laing’s objections to established psychiatric theory and practice are clearly outlined in the introduction to the seminal work he wrote with Aaron Esterson, Sanity, Madness and the Family: ‘In our view it is an assumption, a theory, a hypothesis, but not a fact, that anyone suffers from a condition called ‘schizophrenia’’ (Laing & Esterson 1970: 11).
Laing and Esterson emphasise the fact that even psychiatrists do not agree on who is schizophrenic, and they go on to insist:
No one can deny us the right to disbelieve in the fact of schizophrenia (…). We do not accept ‘schizophrenia’ as being a biochemical, neurophysiological, psychological fact, and we regard it as a palpable error, in the present state of the evidence, to take it to be a fact. Nor do we assume its existence. Nor do we adopt it as a hypothesis. We propose no model of it (Laing & Esterson 1970: 11 [my italics]).
Indeed, in none of his work does Laing propose a model of schizophrenia, nor does he propose a model of the mind, of the psyche or of any coherent metapsychological framework. In Sanity, Madness and the Family, what Laing and Esterson propose instead is that, when studied within the family context, in a certain (phenomenological) way, the behaviour and experience of the so-called schizophrenic becomes far more ‘socially intelligible’ than previously supposed.
In The Divided Self, Laing emphasises that, not only is the psychopathological diagnosis of schizophrenia flawed, but that the premises of psychopathology are themselves fatally flawed: ‘no psychopathological theory is entirely able to surmount the distortion of the person imposed by its own premises even though it may seek to deny these very premises.’ (Laing 1964: 23-24)
These questionable ‘premises’ relate to an approach which engages with the patient on the level of organism, a set of processes, a mechanism which has gone wrong. As demonstrated poignantly by the analogy (Laing 1964: 20) of the image which can either be seen as a vase or as two faces, but cannot be viewed as both simultaneously, it is a ‘distortion of the person’ to view the patient as ‘a complex of things, of its’ (Laing 1964: 22): ‘One’s theory of other as organism is remote from any theory of the other as person.’ (Laing 1964: 21).